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七氟醚与全静脉麻醉对行体外循环冠状动脉搭桥手术患者眼压的影响:一项前瞻性观察研究。

The Effect of Sevoflurane Versus Total Intravenous Anesthesia on Intraocular Pressure in Patients Undergoing Coronary Artery Bypass Graft Surgery with Cardiopulmonary Bypass: A Prospective Observational Study.

作者信息

Tavsanoglu Zeynep Yasemin, Kavakli Ali Sait, Canim Erdem Senay, Karaveli Arzu, Arslan Ulku, Yalcinkaya Adnan, Yener Ali Umit, Dogan Berna

机构信息

Department of Anesthesiology and Reanimation, University of Health Sciences Antalya Training and Research Hospital, 07100 Antalya, Turkey.

Department of Anesthesiology and Reanimation, Faculty of Medicine, Istinye University, 34396 Istanbul, Turkey.

出版信息

Medicina (Kaunas). 2025 May 25;61(6):975. doi: 10.3390/medicina61060975.

Abstract

: The aim of this study was to compare the effects of sevoflurane-based anesthesia and propofol-based total intravenous anesthesia (TIVA) on intraocular pressure (IOP) during coronary artery bypass graft surgery (CABG) with cardiopulmonary bypass (CPB). : This prospective observational monocentric study included 68 patients scheduled for CABG with CPB, divided into two groups of propofol-based TIVA (Group P) and sevoflurane-based anesthesia (Group S). Intraocular pressure was measured and recorded at eight predefined time points using a tonometer: before anesthesia induction (T1), 10 min after induction (T2), immediately before the beginning of CPB (T3), 3 min after the beginning of CPB (T4), 3 min after cross-clamping (T5), 3 min after cross-clamp removal (T6), immediately before the weaning of CPB (T7), and at the end of the surgery (immediately after skin closure) (T8). The primary endpoint was to examine the effects of propofol-based TIVA and sevoflurane-based anesthesia methods on IOP during CABG operation. The secondary endpoints included a comparison of hemodynamic variables, blood gas values, and intensive care unit (ICU) and hospital stays. : Intraocular pressure values were similar for both groups at all time points. A statistically significant decrease was found in IOP in all measurements after induction compared to pre-induction values in both Group P and Group S ( < 0.05). Compared to IOP measured at 10 min after induction, no statistically significant difference was found at all subsequent time points in both groups. When the right and left IOP values were compared, no statistically significant difference was detected at all time points in both Group P and Group S. : The results of the study indicated that propofol-based TIVA and sevoflurane-based anesthesia had similar effects on IOP in patients undergoing CABG with CPB.

摘要

本研究的目的是比较在冠状动脉搭桥手术(CABG)并体外循环(CPB)期间,七氟醚麻醉和丙泊酚全静脉麻醉(TIVA)对眼压(IOP)的影响。 这项前瞻性观察性单中心研究纳入了68例计划行CABG并CPB的患者,分为丙泊酚TIVA组(P组)和七氟醚麻醉组(S组)。使用眼压计在八个预先定义的时间点测量并记录眼压:麻醉诱导前(T1)、诱导后10分钟(T2)、CPB开始前即刻(T3)、CPB开始后3分钟(T4)、阻断主动脉后3分钟(T5)、松开阻断钳后3分钟(T6)、CPB撤离前即刻(T7)以及手术结束时(皮肤缝合后即刻)(T8)。主要终点是研究丙泊酚TIVA和七氟醚麻醉方法对CABG手术期间眼压的影响。次要终点包括比较血流动力学变量、血气值以及重症监护病房(ICU)住院时间和住院总时间。 两组在所有时间点的眼压值相似。与诱导前相比,P组和S组诱导后所有测量的眼压均有统计学显著下降(<0.05)。与诱导后10分钟测量的眼压相比,两组在所有后续时间点均未发现统计学显著差异。比较左右眼眼压值时,P组和S组在所有时间点均未检测到统计学显著差异。 研究结果表明,丙泊酚TIVA和七氟醚麻醉对行CABG并CPB患者的眼压影响相似。

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